School of Economics, Shandong University of Finance and Economics, Jinan, China.
Front Public Health. 2022 Sep 23;10:1020402. doi: 10.3389/fpubh.2022.1020402. eCollection 2022.
The imbalance of medical and health services supply (MHSS) is a significant public health concern as regional economic development disparities widen in China. Based on the provincial panel data of medical and health services, this paper constructed an evaluation index system and used the two-stage nested entropy method to measure the MHSS level of 31 provinces in China from 2005 to 2020. Then we used the standard deviation ellipse, Dagum Gini coefficient, β convergence model, kernel density estimation and Markov chain to investigate the spatial distribution, regional differences, and dynamic evolution of MHSS. According to the results of these analysis, the conclusions are drawn as follows: (1) In general, the MHSS level in China showed a significant up-ward trend from 2005 to 2020. However, the MHSS level among different provinces showed a non-equilibrium characteristic. (2) Regional comparison shows that the eastern region had the highest level, and the central region had the lowest level. The eastern and central regions presented polarization, while the western region showed unremarkable gradient effect. (3) During the period, the overall regional differences, intra-regional differences, and inter-regional differences of MHSS level all showed convergence. (4) The economic development, urbanization rate, fiscal self-sufficiency rate, and foreign direct investment had significant impacts on the convergence. (5) The provinces with high levels had the positive spillover effect. The findings of this paper provide theoretical supports for optimizing the allocation of health resources and improving the equity of MHSS.
医疗服务供给的不平衡是中国在区域经济发展差距不断扩大的情况下一个重大的公共卫生关注点。本文基于省级医疗服务面板数据，构建了评价指标体系，运用两阶段嵌套熵方法测算了 2005-2020 年中国 31 个省份的医疗服务供给水平。接着采用标准差椭圆、Dagum Gini 系数、β收敛模型、核密度估计和马尔科夫链对医疗服务供给水平的空间分布、区域差异和动态演进进行了分析。根据这些分析的结果，得出了以下结论：（1）总体而言，2005-2020 年中国的医疗服务供给水平呈显著上升趋势，但不同省份的医疗服务供给水平存在非均衡特征。（2）区域比较表明，东部地区的水平最高，而中部地区的水平最低。东部和中部地区呈现两极化，而西部地区则没有明显的梯度效应。（3）在此期间，医疗服务供给水平的总体区域差异、区内差异和区际差异均表现出收敛性。（4）经济发展水平、城市化率、财政自给率和实际利用外资金额对收敛性均有显著影响。（5）高水平省份具有积极的溢出效应。本文的研究结果为优化卫生资源配置和提高医疗服务供给的公平性提供了理论支持。
